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Permit CITY OF TIGARD ELECTRICAL PERMIT 1 COMMUNITY DEVELOPMENT Permit #: ELC2012 -00086 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/08/2012 Parcel: 1 S134CB02700 Jurisdiction: Tigard Site address: 12180 SW SUMMER CREST DR Project: Branson Subdivision: SUMMER HILLS PARK Lot: 25 Project Description: Grounding for water service replacement. Contractor: BADGER ELECTRIC INC. Owner: BRANSON 4415 NE SANDY BLVD STE 205 12180 SW SUMMER CREST DR. PORTLAND, OR 97123 TIGARD, OR 97223 PHONE: 503 - 288 -4756 PHONE: FAX: 503 - 493 -7173 FEES Quantity Description Date Amount 1 crt Branch Circuits wo /Purchase 02/08/2012 $56.18 Specifics: Service or Feeder 1 ea 12% State Surcharge - 02/08/2012 $6.74 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $62.92 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in acco •: e approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTEN •N: Oregon law :quires you to follow the rules adopted by the Oregon Utility N. . ation Center. Those mules are set forth in OAR 952 - 001 -0010 hrou. OAR 952 s11-00•0 You may obtain copy of the rules or direct questions to OUNC b :..eri 1987 or 1.800. 32.2344. • Issued By: /� Permittee Signa? 4 . 0 ._ �' r< r OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease or rent. OWNER'S SIGNATURE Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' /i111111111111"1146+—Z _ Date: LICENSE NO. 61(7 Call 503.639.4175 by 7:00 a.m. for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. FEB -7 -2012 10:19A FROM: BADGER ELECTRIC, INC 503- 493 -7173 TO:5035981960 P.2 te e , City of Tigard 13125 SW Hall Blvd., Ti -. ('''''N-,,-",,,,, _ , ,ti Received e a ©i,, — i RxmitNo_ -"Gee j , Plan e v' �C `� a gard; tiR97223 `�,0 Plan Review Phone: 503.639.4171 Fax!503 598.1960 ,. � Date/By: apex Permit: i i i, Inspection Line: 503.639.4175i _.< ;`� Hate Reaady/By: ►huh. 0 See Page 2 for Internet: www.tigard- or.gov `` �� ." " cs�O \ Notified/Method: Supplemental lafermatlea E OF W,O*+ \C . PLAN REVIEW ❑ New construction Addition /alters a i Please deck all that apply (submit a sets of plans w/items checked below), ❑ Demolition ❑Other: �U 0 Service or feeder 400 amps or more ❑ Building over three stories. wherein:, available fault current 0 Marinas sari boatyards. CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or ❑ Floating buildings. d 2 family dwelling ❑ Commerciallindustrial 0 Accessory building less to ground, lot or execedx 14,000 CI C buildings. reial•ttso agricultural rY g amps for all other installations. butrdmgs. ❑ Multi- family ❑ Master builder 0 Other: 0 Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION 0 ' m. larger separately - 3", system. new ❑ Addition of new motor load of ❑ "A ", "E E»", , ""1 -2 »", , " "11 -3 °, Job no.: ! a f D t I Job site address: 12, I g LA .Silo 4 Cam 1' G {- « ❑ R ecreational vehicle 1 - 0 t oxlip or more. six more residential units. tiartca City/State/ZiP: °(t �� a rt n (a • �• O H Hazardous locations. 600 volts nominal. Suite/bldg./apt. no.: Project name: 4.) S CM ❑ Service or feeder 600 amps or more. Cross street/directions to job site: FEE SI:IIED I J Description I Qev. Few l Tau' 1" New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: I Lot no.: 1,000 sq. ft or less 168.54 ' 4 Tax reap /parcel no.: Ea. add'l 500 sq. ft. or portion 33.92 1 Limited energy, residential 67.84 2 DESCRIPTION OF WORK (with above sq. It) l CA..' residential energy, multi-family 67.84 2 6-17/14.1444 residential (with above sal. IL) Services or feeders Installation, alteration, and/or relocation 200 amps or less 100.70 2 ❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2 Name: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 City/State/ZIP: Temporary services or feeders installation, alteration, and /or relocation Phone: ( ) I Fax: ( ) 200 stops or less 59.36 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 ac Branch circuits- new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT l CI CONTACT PERSON above service or Ibeder fee, 7.42 2 each branch circuit Business name: B. Fee for branch circuits without service or feeder fee, that Contact name: branch circuit l 56.18 2 X 6 /. 4 Each add branch circuit 7.42 2 Address: Miscellaneous (service or feeder not Included) City /State/ZIP: Each manuNctured or modular 67.84 2 dwelling, service and/or feeder Phone: ( ) I Fax: : ( ) Reconnect only 67.84 2 E -mail' Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 Signal circuit(s) or limited- energy Business name: / � n0 )/► panel, alteration, or extension. Page 2 , 2 �p r �¢ ` `1� ( �n� Each additional Inspection over allowable in any of the above Address. L G41G) V)3 S/A.l(\!L D tvo a- D u5 Additional inspection (I hr min) 6625/ hr r 2 Investigation (1 hr min) 66.25/ hr City /State/ZIP: Q o C '6.01,A A nu _ 1 Industrial plant (1 hr min) 78. hr Phone: ( 50 N - ti I Fax: ( ) C1(.171_1 i 3 Inspections for which no fee is 90.00/ hr c � / � specifically listed CA hr min) CCB Lic.: ISt ©5 1 I Electrical Lic.: . S y cl Suprv. Lic.:5(4 73 S ELECTRICAL PERMIT FEES Subtotal: 45(0. f g Suprv. Electrician signature, required: Plan review (25% of permit fee): Prim namei'i O �J(� a Cam, , �_ 1 , State surcharge (12% of permit fee): Co , 4 AuthOti2ed si // . � �/ � ` � Dom: y1 - 1 / y_ TOTAL PERMIT FEE: ' l IG .1Jri / F ){ This permit application expires if a permit is not olds ttl wi thin 180 /4V 1 t Print name: 0 a n, I Date: (`� 12 v days after it has been accepted as complete. " l ! I Number of inspections allowed per permit